Atopic hand dermatitis (AHD), a manifestation of atopic dermatitis, can have a profound negative effect on a patient's disease-related quality of life due to its visibility, chronic nature, and overall discomfort that it...Atopic hand dermatitis (AHD), a manifestation of atopic dermatitis, can have a profound negative effect on a patient's disease-related quality of life due to its visibility, chronic nature, and overall discomfort that it causes. AHD differs from other forms of chronic hand eczema due to its likely distinct, complex pathogenesis, which is a combination of environmental triggers, genetic predisposition, and immune dysfunction. A proper diagnosis of AHD is made through clinical evaluation and the ability to establish subtle clinical differences between AHD and other conditions. Diagnosis is the first step to a treatment plan that diverges from a one-size-fits-all approach.
Atopic dermatitis (AD) begins in early childhood in the majority of children. Addressing AD in small children includes recognition of the early presentations of disease in all skin types, triggers, comorbidities, and the...Atopic dermatitis (AD) begins in early childhood in the majority of children. Addressing AD in small children includes recognition of the early presentations of disease in all skin types, triggers, comorbidities, and therapeutics. These include risk of medication absorption, more xerosis, infections, and creating management plans that are acceptable to parents/caregivers, while offering safety. Vaccination efficacy, safety on systemic agents, growth and development, tactile sensory development, and teething-related facial eruptions of early childhood are additional concerns. Prevention of long-term comorbidities is the highest goal. Using age-based considerations helps support excellence in care and improved patient-parent experience.
Atopic dermatitis (AD) and allergic contact dermatitis (ACD) are common inflammatory skin diseases in both children and adults that present similarly and often coexist. Patch testing is the gold standard for establishing...Atopic dermatitis (AD) and allergic contact dermatitis (ACD) are common inflammatory skin diseases in both children and adults that present similarly and often coexist. Patch testing is the gold standard for establishing the diagnosis of ACD and can often help distinct between the 2 conditions. Patch testing is more challenging in patients with underlying AD due to potential for angry back reactions. In this review, we discuss the current evidence and guidelines regarding the screening for contact allergies in patients with AD. We also discuss the most frequent relevant allergens in adults and children with atopic dermatitis.
Recommendations about allergy prevention through diet are rapidly changing. In just the past several years, multiple organizations have provided updated guidance and recommendations about infant feeding based on recent s...Recommendations about allergy prevention through diet are rapidly changing. In just the past several years, multiple organizations have provided updated guidance and recommendations about infant feeding based on recent studies and meta-analyses. In addition to the increased number of studies supporting the benefit of early introduction of allergenic foods, in particular peanut and egg, recent studies demonstrate that infant and maternal diet diversity may also reduce risk of food allergy and atopy. Skin emollients have not been found to be helpful in prevention of food allergy, and more evidence is needed to determine if emollients play a role in prevention of atopic dermatitis.
Atopic dermatitis (AD) is a chronic inflammatory skin condition that can be difficult to treat due to a complex etiology and diverse clinical presentations. Itch is the most common symptom associated with AD with profoun...Atopic dermatitis (AD) is a chronic inflammatory skin condition that can be difficult to treat due to a complex etiology and diverse clinical presentations. Itch is the most common symptom associated with AD with profound negative impact on quality of life. Thus, the adjunctive management of itch in patients with AD is needed to control and reduce disease burden. Supplemental treatment options are continuously emerging and undergoing testing in clinical trials. This article summarizes the latest data on topical and systemic adjunctive therapies for AD safety and efficacy in reducing itch.
Atopic dermatitis (AD) is a chronic inflammatory skin disorder that requires a complex management strategy, which often involves multiple and diverse topicals and systemic treatment regimens. While topical steroids and m...Atopic dermatitis (AD) is a chronic inflammatory skin disorder that requires a complex management strategy, which often involves multiple and diverse topicals and systemic treatment regimens. While topical steroids and more recently calcineurin inhibitors have been the mainstay therapy for mild-to-moderate disease, recent advances in the understanding of AD pathogenesis have led to the development of different new targets, rapidly widening our therapeutic armamentarium. This review summarizes their efficacy and safety data. We also review topical optimization strategies, including the recently published topical volume calculator, to maximize long-term disease control, especially when using multiple agents at the same time.
Patients with atopic dermatitis (AD) are at increased risk of atopic and non-atopic comorbidities. In fact, the Hanifin and Rajka criteria include allergic and infectious comorbidities as a minor criterion. Despite the w...Patients with atopic dermatitis (AD) are at increased risk of atopic and non-atopic comorbidities. In fact, the Hanifin and Rajka criteria include allergic and infectious comorbidities as a minor criterion. Despite the well-recognized list of comorbidities, the past 15 years greatly expanded the list of recognized comorbidities of AD. This narrative review focuses on comorbidities of AD using a mnemonic, VINDICATE-P: vascular/cardiovascular, infectious, neoplastic and neurologic, degenerative, iatrogenic, congenital, atopic and autoimmune, traumatic, endocrine/metabolic, and psychiatric. The comorbidities of AD vary by age. More research is needed into the mechanisms of comorbidities and optimal screening strategies in AD patients.
Atopic dermatitis is an inflammatory skin condition that largely affects children. Atopic dermatitis has the potential to persist into adulthood and continue to negatively affect the lives of those who are burdened with...Atopic dermatitis is an inflammatory skin condition that largely affects children. Atopic dermatitis has the potential to persist into adulthood and continue to negatively affect the lives of those who are burdened with it. This condition can have a large impact on the quality of life of those who are affected from birth through senescence. Scoring systems have been developed over time to help assess the impact that AD has on an individual's quality of life. The goal of this article is to create an overview of the quality of life scores by age group and across nationalities.
Atopic dermatitis (AD) is a complex, chronic disease with multiple negative impacts to patients' health, lives, and overall well-being. The lived experience of AD is multidimensional, heterogeneous, and ever-changing, ye...Atopic dermatitis (AD) is a complex, chronic disease with multiple negative impacts to patients' health, lives, and overall well-being. The lived experience of AD is multidimensional, heterogeneous, and ever-changing, yet an essential contributor to a holistic understanding of disease burden. Real-world self-monitoring of disease burden by patients has potential as a valuable adjunct to clinical and patient-reported assessments in health care settings. Newer digital tools are available to support these activities, providing opportunity for patients and health care providers to identify aspects of self-monitoring that can best support AD care and management goals, treatment outcomes, and minimize patient burden.
Atopic dermatitis (AD) and food allergies are 2 atopic conditions that tend to develop early in life. Their interrelationship has been a topic of controversy and many studies. The presence of atopic dermatitis in infancy...Atopic dermatitis (AD) and food allergies are 2 atopic conditions that tend to develop early in life. Their interrelationship has been a topic of controversy and many studies. The presence of atopic dermatitis in infancy and early childhood, particularly if severe, is a risk factor for the development of immunoglobulin E (IgE) -mediated food allergies. While it is common for children with AD to demonstrate extensive sensitization to foods, serum IgE testing is not always indicative of clinical allergy.
Atopic Dermatitis (AD) is a common, pruritic inflammatory skin disease associated with marked disease burden and substantial health care costs. AD does not discriminate between populations; prevalence estimates vary wide...Atopic Dermatitis (AD) is a common, pruritic inflammatory skin disease associated with marked disease burden and substantial health care costs. AD does not discriminate between populations; prevalence estimates vary widely with most studies focusing on general or pediatric populations and a limited number of studies in adult populations solely. The costs of treating AD are staggering. Studies that examine differences in prevalence may be difficult to compare due to differences in study designs. However, understanding the prevalence of AD across populations is critical if we are to improve the lives of patients and caregivers living with this disease.
The longitudinal course of atopic dermatitis (AD) is heterogeneous and complex. While previously thought to be a childhood disorder, recent studies demonstrated that childhood-onset AD may take several different courses...The longitudinal course of atopic dermatitis (AD) is heterogeneous and complex. While previously thought to be a childhood disorder, recent studies demonstrated that childhood-onset AD may take several different courses that may involve persistence into adulthood becoming a lifelong condition. Other patients only demonstrated adult-onset AD. Different factors may play a role in the timing of AD onset. Assessing the longitudinal course also involves understanding the changing temporal pattern of AD. Understanding the dynamic course of AD is important in identifying individualized treatment recommendations for patients.
Race, ethnicity, language, sex, age, income, insurance status, location, and other socioeconomic and demographic factors influence access to and quality of care for patients with psoriasis, which can potentially lead to...Race, ethnicity, language, sex, age, income, insurance status, location, and other socioeconomic and demographic factors influence access to and quality of care for patients with psoriasis, which can potentially lead to inequitable outcomes.
Understanding the underlying causes of nonadherence among patients with psoriasis and adopting strategies to address these issues may allow providers to share responsibility and work alongside patients to overcome these...Understanding the underlying causes of nonadherence among patients with psoriasis and adopting strategies to address these issues may allow providers to share responsibility and work alongside patients to overcome these barriers. The review explores patient adherence to different types of psoriasis treatment, suggestions for interventions to overcome barriers, and methods to promote adherence that have been published in the literature.
Immune checkpoint inhibitors (ICIs) are effective antitumor agents but are associated with immune-related adverse events. ICI-induced psoriasis commonly presents in patients with a history of psoriasis but may occur de n...Immune checkpoint inhibitors (ICIs) are effective antitumor agents but are associated with immune-related adverse events. ICI-induced psoriasis commonly presents in patients with a history of psoriasis but may occur de novo, and it has a significant physical and psychosocial impact. ICI-induced and non-ICI-induced psoriasis are likely mediated by similar cytokines, and similar treatments are employed. Topical treatment often suffices, and when needed, several systemic treatments appear to be effective without impacting antitumor response. Development of psoriasis may indicate a superior response to ICIs. Thus, recognition and management of ICI-induced psoriasis is essential to avoid ICI interruption and maximize therapeutic potential.
Cytokine blocking therapies have revolutionized the management of psoriasis and atopic dermatitis but can lead to the development of paradoxic psoriasis (PP). Patients treated with biologics should be closely monitored f...Cytokine blocking therapies have revolutionized the management of psoriasis and atopic dermatitis but can lead to the development of paradoxic psoriasis (PP). Patients treated with biologics should be closely monitored for the development of PP and other paradoxical eruptions (including inflammatory joint disease, inflammatory bowel disease, eczematous eruptions, lupus like eruptions, sarcoidal eruptions, and others) and occasionally the development of cutaneous T-cell lymphoma. Further understanding the immunologic mechanism of these processes will ultimately drive our understanding of and ability to predict and manage PPs.
This review highlights advances made in psoriasis genetics, including findings from genome-wide association studies, exome-sequencing studies, and copy number variant studies. The impact of genetic variants on various co...This review highlights advances made in psoriasis genetics, including findings from genome-wide association studies, exome-sequencing studies, and copy number variant studies. The impact of genetic variants on various comorbidities and therapeutic responses is discussed.
Psoriatic arthritis (PsA) is a systemic chronic inflammatory disease that develops in up to 30% of patients with psoriasis. Mixed data variably support the potential ability to "prevent" and/or delay PsA through use of s...Psoriatic arthritis (PsA) is a systemic chronic inflammatory disease that develops in up to 30% of patients with psoriasis. Mixed data variably support the potential ability to "prevent" and/or delay PsA through use of systemic therapies in psoriasis patients. Though intriguing, almost all of these studies are retrospective in nature, and hold substantial limitations and potential biases that challenge the ability to meaningfully interpretation their results. Thus, the authors believe prospective observational and interventional studies are crucial to understanding our ability to truly modify the transition from psoriasis to psoriatic arthritis and delay or prevent PsA onset.